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ORIGINAL ARTICLE
Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Glostrup, Denmark, and
Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Hvidovre, Denmark
Abstract
Introduction: Commercial virtual reality games have been used as adjunct therapy for stroke rehabilitation, mainly after
patients have been discharged. The aim of this study was to explore stroke patients experiences with Wii Sports as a
supplement to conventional occupational therapy in a controlled hospital setting. Materials and methods: The study had a
qualitative triangulation design that included semi-structured interviews and eld notes. Nine Danish stroke patients
participated, receiving between one and nine interventions with Wii Sports during a three-week period. Responses were
coded by qualitative content analysis. Results: Analysis revealed one overarching category, Connecting to past, present, and
future occupations, and three categories that encompassed patients experiences with Wii: (i) variety, (ii) engagement, and
(iii) obstacles and challenges. Interview ndings were conrmed by eld notes that included observations of engagement and
challenges. Discussion: Stroke patients in hospital settings may experience Wii Sports as a benecial and challenging
occupation for both rehabilitation and leisure. Incorporation of Wii Sports into conventional occupational therapy services
may benet patient rehabilitation directly or provide motivation for alternative leisure activities.
Key words: stroke, rehabilitation, qualitative content analysis, Nintendo Wii, leisure
Introduction
In Denmark, 30 00040 000 people are currently
living with some level of disability as a consequence
of stroke (1). According to the Danish National
Board of Health, approximately 12 500 people
were hospitalized due to stroke in 2009 (2). Early
rehabilitation is critical as maximum improvements
in activities of daily living (ADL) are achieved within
the rst ve months after stroke (3). Occupational
therapy is integral to improving ADL (46). According to the Canadian Model of Occupational Performance and Engagement (CMOP-E), the overall
aims of occupational therapy are to promote engagement in everyday living and to maximize independence through meaningful or necessary occupations
(7,8). Common occupations during inpatient stroke
Correspondence: D. Celinder, Occupational Therapist, Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Glostrup,
Nordre Ringvej 57, DK-2600 Glostrup, Denmark. Tel: +45 38633106. Fax: +45 38633913. E-mail: domace01@regionh.dk
(Received 19 June 2011; revised 1 January 2012; accepted 3 January 2012)
ISSN 1103-8128 print/ISSN 1651-2014 online 2012 Informa Healthcare
DOI: 10.3109/11038128.2012.655307
458
Notes: All names are pseudonyms. The Wii hand and number of Wii sessions are derived from eld notes. Abbreviations: M = male; F = female; I = ischaemic; H = haemorrhagic; ND = not described;
L = left; R = right.
6
6
8
7
Wii sessions
First L,
then R
R
R
Both
Wii hand
First L,
then R
43
24
46
41
Duration of hospital stay
before enrolment (days)
29
44
17
27
ND
R
R
R
Impaired
problem solving
R
L
Impaired
initiative
R
R
Impaired
initiative
Cognitive impairment
Hand dominance
Left side
inattention
Uncritical
Impaired
problem solving
L
L
Left side
neglect
ND
H
I
ND
None
I
I
R
L
R
I
Stroke type
71
62
68
81
71
M
M
60
Age
55
95
51
Left side
inattention
Ivan
Flora
Gender
Anton
Birgitte
Christian
Dan
Elias
Gabriella
Hans
459
Variety
Engagement
Excitement and
motivation
Being disappointed
New topic of
conversation
Gaining control
and benets
Physical challenges
Desiring meaningful
occupations
Wishing to play
Wii again
Cognitive challenges
460
461
462
463
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